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The association between integrity of the photoreceptor inner segment-outer segment junction and visual acuity in diabetic macular edema

Session Details

Session Title: Imaging IV

Session Date/Time: Sunday 20/09/2015 | 11:00-13:00

Paper Time: 11:40

Venue: Thalie.

First Author: : s.arfeen EGYPT

Co Author(s): :                  

Abstract Details

PURPOSE:To evaluate the integrity of the photoreceptor inner segment/outer segment (IS/OS) junction using spectral-domain optical coherence tomography (SD OCT) in patients with diabetic macular edema and to correlate the relationship between the integrity of the IS/OS junction and visual acuity

Setting:

Patients were recruited from the outpatient clinic of Kasr El-Aini Hospital – Cairo University in the period from June 2011 to January 2012. OCT was done at Bostan Diagnostic Eye Center.

Methods:

40 eyes of 22 diabetic patients having diabetic macular edema. The authors performed spectral-domain optical coherence tomography in all eyes before treatment,1month and 6 months after treatment. The authors defined central subfield thickness as the average retinal thickness of the1-mm central scanned area. The length of disruption of the inner and outer segments of the photoreceptors in the fovea were measured and graded according to their length as follows: grade 0 : intact IS/OS line (no disruption at all),grade 1: mild disruption (<400microns).grade 2: moderate disruption (>400 microns but <1400 microns), Grade 3: severe disruption ( >1400 microns )or completely lost

Results:

At baseline, there was no correlation between the VA and grade of defect (r= 0.214, p-value= 0.190). After one month and six months of treatment , there was moderate correlation between the VA and the grade of the defect ( r = 0.538 , p-value < 0.001) (r =0.603, p value < 0.001) respectively .There was no significant association between the improvement in the IS/OS and final VA( p-value < 0.385). The mean change in VA from base line to 1 month in those who showed improvement in the defect was better than those in the non improved group (p value =0.001) , and the mean change in the VA values from base line to 6 months in the improved group was better than those in the non improved group (p value= 0.001).

Conclusions:

This study indicated that the status of photoreceptor layer in OCT has a moderate relation with visual acuity, it means that patients with DME with an intact IS/OS junction have a better visual acuity, however we did not find an association between the improvement of the defect and improvement of visual acuity. We also reported inconsistency of the status of the IS/OS during follow up period which may be related to several factors ,these findings suggest that investigation of other, novel, OCT-derived parameters may be warranted to allow the construction of models that show stronger correlations with visual function in patients with DME

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